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Fast Facts

Most common causes of swollen lymph nodes aren't directly related to RA.

It's important to find out what might be causing swollen glands so you can get the right treatment.

Lymphoma isn’t common with RA, but your doctors may want to rule it out.

You have hundreds of lymph nodes throughout your body, and large clusters of them in three particular areas: your neck, your armpits, and your groin.

Lymph nodes (also known as glands) filter waste out of lymph, a sticky, see-through fluid that contains white blood cells, which help fight infection. In short, lymph nodes help keep you healthy.

When lymph nodes become swollen or enlarged, doctors refer to the condition as lymphadenopathy. Sometimes the swelling is localized (in only one place in the body), and sometimes it's diffuse (throughout the body).

Seeing or feeling a lump, especially in your neck, armpit, or groin, can be a symptom of lymphadenopathy. Some swollen lymph nodes may be only slightly noticeable. The lump may or may not be tender or painful, and you might feel one lump or several.

What Causes Swollen Glands?

According to Scott Zashin, MD, an internist and rheumatologist in Dallas, there are several common causes of lymphadenopathy, and most are not directly related to rheumatoid arthritis. But some are in the same general category of rheumatic diseases as RA.

Dr. Zashin explains some of the possible root causes of swollen glands:

An infection Both viral and bacterial infections can cause lymph node swelling, including strep throat, the common cold, measles, mononucleosis, an ear infection, a tooth infection, HIV, or a skin infection. If the trigger is a bacterial infection, you may need an antibiotic. If it's a viral infection, you may just have to wait it out.

Sjögrens syndrome Some people who have inflammatory arthritis also develop Sjögrens syndrome. Common symptoms of this autoimmune disease include dry eyes, mouth, and skin, as well as swelling of the parotid glands, which are located in front of and below the ears. A small number of people with Sjögrens may have enlarged lymph nodes.

Still's disease This form of inflammatory arthritis is rare in adults, but people with Still's disease may develop lymphadenopathy. "In 30 years, I might have had one or two patients with this," says Zashin. People with Still's disease who have swollen lymph nodes may also have a fever, rash, and an enlarged liver and spleen.

Cancer Many kinds of cancer can cause swollen lymph nodes. People who have rheumatoid arthritis, as well as those who have Sjögrens syndrome, are at higher risk for developing lymphoma, a cancer of the lymphatic system, compared to those who don’t have these conditions. "Lymphoma is not common with rheumatoid arthritis, but it does correlate with disease activity. So the higher the disease activity, the higher the risk of lymphoma," says Zashin. Early studies have hinted that some drugs used to treat RA, known as biologics, might increase lymphoma risk. While that can't be excluded as a possibility — and the topic is still under debate — more recent research suggests that biologics do not increase lymphoma risk. Beyond swollen nodes, other common symptoms of lymphoma include weight loss, rash, fever, and unusual fatigue or bleeding.

Very active, uncontrolled rheumatoid arthritis, especially if the condition has lasted for many years "It's rare, but you can sometimes see lymph node enlargement related to rheumatoid arthritis activity," Zashin says. "This is usually more of a diagnosis of exclusion." In other words, your doctor will probably want to rule out other possible causes of swollen glands first, such as infection or cancer, before blaming your rheumatoid arthritis. "I would refer a patient to an oncologist unless I saw an obvious reason for it, like if the patient has mono or another infection," he says.

Treatment of swollen lymph nodes varies widely, depending on the cause. If you alert your doctor about your symptoms right away, you can work together to figure out next steps. You might be prescribed antibiotics, advised to watch your condition and wait to see if it gets worse, or be called into the office for a biopsy. Whether the cause is serious or not, your doctor can help steer you in the right direction and get you feeling your best again.